LAUSR

On March 15, 2015, the National Center for Health Statistics at the Centers for Disease Control and Prevention released data from the Native Hawaiian and Pacific Islander (NHPI) National Health Interview Survey (NHIS). This project was jointly supported by the Office of Minority Health at the US Department of Health and Human Services (HHS), and it was the first national health survey to use a sample frame consisting of NHPI households. This project was the result of years of advocacy by Asian American, Native Hawaiian, and Pacific Islander community organizations, leaders, and health researchers, combined with advancements in federal policies on data collection standards for racial/ethnic populations. In 1985, HHS released a landmark report, the Report of the Secretary’s Task Force on Black & Minority Health, also known as the Heckler Report, named after former HHS Secretary Margaret Heckler. This report highlighted the health status of Asians/Pacific Islanders, black people, Hispanic people, and Native Americans, and it thrust the health disparities of racial/ethnic populations in the United States to the national stage. The report acknowledged that data for the Asian and Pacific Islander populations were limited. In addition, data were not disaggregated for these subgroups, thereby making this population appear healthier than other racial/ethnic minority groups. Data collected from Asian American, Native Hawaiian, and Pacific Islander respondents were aggregated under a single Asian and Pacific Islander racial/ethnic category, potentially masking differences in health status and behaviors. One of the most important developments after the release of this report was the creation of HHS’s Office of Minority Health in 1986. The Office of Minority Health was charged with improving the health and well-being of racial/ethnic minority populations through the development of programs and health policies with the aim of eliminating health disparities and achieving health equity in these populations. Another development was that advocates representing Asian American, Native Hawaiian, and Pacific Islander communities organized themselves in that same year to work with the federal government and advocate for policies addressing the health of Asian American, Native Hawaiian, and Pacific Islander populations. According to the 2010 US Census, approximately 1.2 million people identify as NHPI, either alone or in combination with at least 1 other race, reside in the United States, and represent about 0.4% of the total US population. Based on limited available data, NHPI people have a persistent, disproportionate share of health problems, compared with other demographic groups, including high rates of chronic health conditions such as high blood pressure, diabetes, and heart disease. NHPI people are nearly twice as likely as white people to be diagnosed with diabetes. NHPI people are almost 4 times as likely as Asians to be obese, one of the leading risk factors for many chronic conditions such as diabetes, heart disease, and several cancers. Native Hawaiian men and women in Hawaii and California have mortality rates from heart attacks and other heart diseases that are almost twice as high as those of white people. However, the paucity of health data at the national level has limited our ability to fully understand the range and depth of health issues of the NHPI population. To understand the underlying causes and consequences of health disparities faced by the NHPI population, better data are needed. Data collection was facilitated through changes in data policies. In 1997, “Native Hawaiian or Other Pacific Islander” officially became a distinct racial group for federal purposes, when the Office of Management and Budget began requiring federal agencies to use a minimum of 5 race categories including NHPI. The 2010 Affordable Care Act further promoted disaggregation in data collection. Specifically, §4302 of the Act required that, to the extent practicable, sufficient data should be collected in federal public health surveys to generate statistically reliable estimates for all racial/ethnic groups. In response, HHS promulgated standards for data collection on race/ethnicity, primary language, sex, and disability status. The HHS data standards distinguished Native Hawaiian from Pacific Islander and expanded